Health insurance is dragging out the same old tired attacks on reform

Here we go again.  They show up at the table and talk about how ready they are to reform and as soon as your back is turned, look out for the knife.

Health care reform requires three legs:
 - people have access to care (coverage)
 - we change the way the money flows inside health care (payment reform)
 - we change the way health care works (health care re-design)

Right now we're in this horrible stalemate in which we can't deliver on more than the little bits of primary care due to the lack of willingness of the insurance industry to fund the full scope of work.  We could do so much more to meet the needs of our patients if we could afford really good information systems and work collaboratively across silos to coordinate and improve outcomes.

What's in the way of this work?  The companies with the money won't fund the work.
Worse than that, they keep us running around chasing down details to satisfy their clerks to the tune of $31Billion per year in extra costs to medical practices alone.

Want to talk about denying choice?  Let's talk about the insurance clerks who deny care, deny procedures, deny referrals, deny drugs?  The current insurance stranglehold is not a system of free choice.

Want to talk about rationing?  Let's talk about creating co-payment that are prohibitive and make it so hard that many people skip needed doses of medicine to make the pills 'last longer.'  How about denying access to certain doctors or procedures based on insurance company rules?  How about "Pre-existing conditions" not being covered?  How about "this is not a covered benefit?"  The current insurance stranglehold is rich with rationing.

Want to talk about a system that results in waits and delays?  Let's talk about patients being told that they can't start their cancer treatment until approved by an insurance clerk and then reviewed by an insurance medical director.  How about prior authorization requirements that take endless paperwork and tie medical practices and patients up in administrative knots.  The current insurance stranglehold is a system of intolerable waits and delays.

To imply that we now have a system in which ANY patient can get the care they need with FULL CHOICE and NO HASSLE and NO DELAYS is flatly untrue. 

Don't be fooled by the insurance industry propaganda - they have a clear objective to keep their stranglehold on the money and total control over our miserable system.

Read more by Paul Krugman on this issue.

Comments

[Owen H. Lucas MD MMM]

It will be interesting to observe the resistance to change to the healthcare system. Look carefully and see if you can see the link between not changing the system and the complainer's revenue and profits. You will not see altruism amongst the complainers...only greed and self interest. They are not interested in the end user's improved outcomes, access, or reduced costs.